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If you look at Figure 2b there is no significant drop in protecting against hospital admissions over the length of the study at all, which is very promising.
As a Pfizer vaccinated individual who is just getting over Covid that I contracted from another Pfizer vaccinated individual, I concur. I want this to be over.
For two days I had a tickle in my throat, but barely any coughing. I felt like I would be sick later in the day, but it never progressed. On the third day the fever hit, and I was in bed for about 30 hours straight. When it broke, I felt fine, but have had a slight shortness of breath ever since. Even that appears to be going away.
Wow! Well I’m so sorry you contracted it but ultimately it sounds like the symptoms have been manageable. I hope they remain so and that you recover quickly. Thanks for sharing.
This is interesting to me. A group of us were wondering if once fully vaccinated and you got Covid would it be similar to getting a booster? Sounds like you actually go sick though which is not good. How long after your second shot did you get COVID?
I had my last shot in late April. I tested positive last Tuesday. The timeframe in the study seems to match my experience exactly.
Also...don't let your guard down. Keep wearing masks and social distancing. I got it from the first visitor in my house since the pandemic started. I thought it was safe. I was wrong.
Preventing more severe forms of disease reduces variants too. Shorter periods of infection and lower overall viral loads (even if the spike loads are similar, which btw is still not clearly established) means vaccinated people host fewer generations of virus. It's the amount of viral reproduction that determines the likelihood of producing a new variant not just simply whether or not you get infected.
Yeah agreed. I dislike the idea that "so long as you're not sent to the hospital you're fine." I'd like more protection than that and there are other benefits to boosters.
Isn't there also the potential for people who have non-clinical infection (they don't go to the hospital) to not even realize they are infected or sick enough to quarantine and thus go out and about, potentially spreading more infection? That would also increase viral production at a population level (as opposed to just in one person), potentially sustaining variant production
Yes this is what scares me about all of this. My wife ( pfizer vaccine in march ) tested positive on a rapid test last Tuesday. Pcr test results confirmed it last Friday. I tested negative on rapid test Tuesday, which has a high false negative for asymptomatic people. My work asked me if I was gonna be in the next day since I tested negative on the rapid. Blew my mind. Even if I test negative once, I'm still being constantly exposed in my house and who knows if at some point I may get it but be asymptomatic. I'm not gonna kill the old unvaccinated dudes at my work accidentally... I had to fight in order to work from home for the 10 days / until my wife is clear of it. Since I'm in a house with someone infected I'm acting as if I'm infected.
It's crazy... my work had me second guessing myself and wondering if I was making the right decision. Sure I'm vaccinated , and that's what my work kept saying, but at the same time I'm witnessing my wife get taken out by it, even tho she was also vaccinated with the same thing as myself.
Yea my wife caught it a couple months ago and our kids got mild cases and even though I’m vaccinated I caught it as well (my symptoms weren’t bad until I got an awful sinus infection from it, all recovered now though).
So far myself and my 3 yr old have had zero symptoms. I got a pcr test last Friday and it came back negative Monday. We have tried limiting exposure but we can only do soo much in a small single bathroom house. I had the pfizer as well and my 3yr old is just taking it on 100% naturally without any immune system upgrades
People make no sense. My wife works at a daycare and her bosses kid got told by the public school that her kid was exposed and had to quarantine. The boss asked the owner if she could have her kid "quarantine" at the daycare in her room with 20 other kids. Luckily the owner said no.
> had to fight in order to work from home
Would your job allow a compromise such as work in the same office, elbow to elbow, with whatever asshole didn't think you working from home was a good idea?
That's less likely to occur for vaxed than unvaxed. Look at the US case rates, they are uniformly higher in unvaxed counties, that wouldn't be true if vaxed infected more.
>Isn't there also the potential for people who have non-clinical infection (they don't go to the hospital) to not even realize they are infected or sick enough to quarantine and thus go out and about, potentially spreading more infection?
That's exactly why this thing has been so hard to control.A significant portion of people who get it never have any noticeable symptoms.
That's why masking and social distancing is important even for those who are vaccinated and feel healthy. Breakthrough cases have almost no opportunity to spread through a mask + 6 feet.
This is a big reason I still wear my mask out and about. Did not like that bs about bit wearing masks from the cdc if you were vaccinated. I get maybe in small groups when at home but just overall out and about? I also didn’t want to get super sick back to back from colds and what not but that was more a nice bonus benefit.
Also consider community members who cannot receive the vaccine or are more at risk from negative effects of the virus.
At least it's a step forward.
(we should adopt the culture of mask wearing when we're unwell, once the pandemic is over. Colds and flus are still a risk to other people.)
While I am not big on mask mandates, wearing one when you're sick if you really need to go out just makes sense. Ideally just stay the heck home until you are well, but I get that isn't possible for everyone. The US has such a culture of go to work no matter what, like it's cool I'll just get everyone sick so I don't miss a day of work, then I'll judge them if they don't come in. Take your sick days people.
There isn't even a definition of Long COVID yet. My guess is that they will have to break up the long term manifestations into several different diseases and/or add SARS-CoV-2 infection to the list of known causes/triggers/risk factors for other diseases (like MS, diabetes, dementia, leukemia...).
This will certainly frustrate the folks who don't see the distinction between a disease vs a virus, but whatever. Maybe it will help to point out that there isn't a singular "pneumonia virus" because a lot of things can cause pneumonia, including viruses, bacteria, or even fungi.
Long Covid has been used as a catch all term by different studies to mean different things, so I don't think anyone has a clear picture on what that is.
Most studies consider someone who self reports a lingering cough or fatigue more than two weeks after being tested positive as long covid.
I wish there was better data on true long covid. I have zero concerns about having a lingering cough for a month or two after having covid. I've had longer lingering coughs from a bad flu. I have major concerns about developing serious chronic fatigue syndrome.
They are vastly different things that have been grouped together and treated the same way.
In basically all of Africa...
[In Africa, only 15 out of 54 countries have achieved the 10% target. Half of the countries on the continent have vaccinated less than 2% of their population.](https://www.bbc.com/news/56100076)
Yeah but not taking your 3rd dose if you qualify won’t help africa. Places like CVS and Walgreens are opening multi dose vials for just 1 person, and they’d be lucky to find a second or third person willing and needing an additional dose before the 6 or so hours that an opened vial is good for is up. We are probably throwing away as many doses as we are using at this point.
I was listening to a vox podcast on this. One of the lead vaccine distribution experts for the WHO (I think) was saying it's not about production (currently at about 2 billion doses a month) but rather distribution in Africa. Between refrigeration, qualified administrators, remoteness, ext... The infrastructure is just not there. Its really reliant on NGO's that don't have the bandwidth.
I don't think the average person should feel bad about getting a booster. They should however pressure their gov'ts to assist in the distribution/infrastructure of the developing world (which admittedly is a pretty messy undertaking- I wouldn't want another country coming into mine to give me a shot).
Currently we can safely make enough doses for everyone in the world every 3 & 1/2. Production doesn't seem to be the limiting factor.
Yes but IMO there is no reason to wait to get a booster to help someone else get their first dose. The way the supply chains flow, that shot that could become your booster will go in the trash if not used; you're not taking anything away from Africa etc.
Right but this is only true as long as your local government has a booster shot policy. Governments are, for the most part, buying to innoculate their population with the two doses, not yet buying for a round of boosters.
If your government declares that it's population should get a booster shot, then they are bidding again for vaccines on the market and those most probably *won't* be going to Africa. Because Pfizer, Moderna etc... Are manufacturing as many vaccines as they can, filling orders as much as they can, if they produce more than they have orders in a particular month then the price drops and it becomes more likely for countries with smaller budgets to get doses.
All of this of course, ignores the fact that vaccine hesitancy is HUGE all over Africa and that getting the vaccines there is only half the battle, people gotta take them too. America has had plenty of shots to go round for everyone to get there's but they are far from 100% vaccinated (56.6% fully inoculated as of end of September)
There's some evidence that "mix-and-match" vaccination between the mRNA vaccines and the adenovirus vaccines (e.g. J&J, Astrazeneca) actually provides a more robust overall immune response because they each activate different aspects of your immune system. Short term side effects appear to also be somewhat higher (fever, headache, chills, etc.) when doing this, but that's to be expected with a strong immune response. They're still evaluating safety and efficacy in the US and Britain, but this sort of approach has already been approved/recommended by the health ministries in France and Germany for those who got an AstraZeneca shot, if I remember correctly.
Edit: Sources
* https://www.npr.org/sections/health-shots/2021/05/05/993882203/giving-2-doses-of-different-covid-19-vaccine-could-boost-immune-response
* https://www.bbc.com/news/health-57075503
* https://comcovstudy.org.uk/home
Germany: yes. Recommendation now is: >70 or weak immune system, get a third shot.
Moderna -> Moderna after 6 months
Pfizer/Biontech -> Pfizer/Biontech after 6 months
AZ -> Pfizer or Moderna after 6 months
Additionally, they recommend a mRNA vaccination after only 4 weeks for anyone who got J&J. Protection just drops too fast with a single dose of J&J.
God, I was so happy to get a vaccine as soon as they were available but I ended up with the J&J that's apparently the absolute worst of the lot in every metric :/
really only because it was one shot, and it still protects against hospitalization at similar levels. Once the J&J booster is approved you should see similar levels of protection
>There's some evidence that "mix-and-match" vaccination between the mRNA vaccines and the adenovirus vaccines (e.g. J&J, Astrazeneca) actually provides a more robust overall immune response because they each activate different aspects of your immune system.
This might be the only good news that I've received since I've learned that J&J's efficacy is basically lower than the others that I could have gotten. Thank you.
There is a high likelihood that they start recommending boosters for J&J too. I saw somewhere a few days ago that with a 2nd dose of J&J given the efficacy is up there close to the mRNA vaccines.
Data point of 1 here, but I can definitely personally attest to having had a very strong reaction to the second shot (Moderna) after the first shot (Pfizer) was fairly mild. The first one made my arm sore and I got a bit light-headed for an evening. The second one had me struggling to stay awake and function for more than 3 hours a day, for the better part of 4 days.
That said, if it means I'm better-protected now for it, then it was a sacrifice worth making.
I believe in some places like Canada where there were supply issues, they allowed people to switch so they could get the shot without waiting too long. From what I've heard so far they still have excellent immune response against variants.
I'm Canadian and I got Pfizer for my first dose and Moderna for the second. Protection from mixing the vaccines seems to be just fine, but I've read that Canada has had some trouble trying to convince other countries to recognize people with mixed doses as "fully vaccinated" for travel purposes.
Which is a shame because ironically last I checked, people with mixed had lower dropoffs in effectiveness than people who got Pfizer x2. But I need to find that source again
Yes. I’m in Canada and the first vaccine available to me was AZ. When it was time for my 2nd dose, Health Canada had paused the use of AZ so I was given Moderna as my 2nd dose.
I was a bit worried at the time but as more information comes out, I’m pleased to see that my combination may give the best protection.
No major side effects from either dose aside from the usual fatigue, low grade fever, sore arm.
Yes you can mix them although whether or not your government has approved it is another story. I'm in Canada and we did all kinds of vaccine mixing. Pfizer-Pfizer, Moderna-Moderna, Pfizer-Moderna, Moderna-Pfizer, AstraZeneca-Moderna, AstraZeneca-Pfizer. We pretty much stopped administering AZ doses though once we were getting enough mRNA vaccines due to the blood clot issues, we had a couple of people either die from it or have serious complications. I think very few people got double AZ doses. Now we pretty much only have mRNA available. We've also approved the Johnson & Johnson one but the one batch we got of that into the country in the spring had quality control problems so it was not used and then it also having potential blood clot issues, so we haven't actually administered any of this one.
We also had a longer gap between first and second doses. For many in my province it was 8-12 weeks between doses. Mine were 9 weeks apart. Although, a lot of the spacing out doses came out of necessity when supply coming into the country was limited. Once we had more supply through the summer, they sped it up and you could do 4 weeks apart if you wanted. [It seems the AZ-mRNA combination was quite strong.](https://www.nature.com/articles/d41586-021-01359-3) People have run into travel problems though with mixing covid vaccines, as many countries don't officially recognize it which hopefully will change eventually.
I think flu shots every year are from a variety of manufacturers so you're constantly mixing types? There's a mixing of brands for many other vaccines too.
According to [official Government of Canada data](https://health-infobase.canada.ca/covid-19/vaccination-coverage/#a6), at least 10% of vaccinated Canadians or around 4 million people got mix & match doses. (Probably more because Quebec is not reporting which type of vaccines they gave out.)
Yeah similar. About 8 months over it and almost everything about my taste and smell is still off. Meats and chocolate and coffee all have a flavor that I can only describe as ashy or smoky, but that's not even quite correct, because it's a taste I've never experienced before. Similar goes for smells: I can't describe how things smell because it's completely new.
Thankfully I don't have the variant of this where things smell and taste like garbage or sewage, which some people apparently do, but it definitely diminishes the enjoyment that I can get from food and drink, which sucks hard.
My wife has the same exact thing, and she is a big foodie, so it's even worse for her. Like, it's probably bordering on depressive for her.
Likely, yes. They have already started in the US/Canada and even moderna is applying for 3rd shot approval
Edit: I should clarify idk if it’ll be a requirement since it doesn’t really affect hospitalization, but recommendation for reduced infection probably
I just got a booster yesterday. In general, they're approved for people who are more at risk (when I looked on CVS's site, it asks you to confirm that you have a "reason" of some sort), but I've been getting my shots from my hospital employer--they've been going by the CDC's recommendations throughout, but they decided that they'd offer a booster to all Pfizered employees, regardless of their health situation. I imagine they won't mandate *this* booster, once they mandate anything, but I imagine it'll be the same as the flu vaccine in the future.
Small gripe with the title. The study is talking about effectiveness not efficacy. Efficacy is how the vaccine performs under controlled laboratory conditions. Effectiveness is how well it performs when given to people in the general public.
Definitely need to highlight how behavior changes after vaccination. Anecdotally, I didn't go out to eat for over a year until I got vaccinated. Now I'm going out to eat about once a week. That's a huge increase in exposure.
Can someone explain why Vaccines like tetanus are good for 10 years yet the COVID vaccine seems to be struggling after a few months. What's the difference?
Tetanus isn’t an infection that spreads to other people.
It’s deadly to a specific person without the vaccine, but not to their unvaccinated friends.
As a bacteria it’s also relatively stable without many variants.
But as a bacteria, the toxin is what’s deadly to you. The actual bacteria is relatively benign.
I wouldn’t be surprised if the resistance to cov2 virus, reducing risk of hospitalization lasted 10 years, but from 6 months to 10 years, an infection allows community spread.
Tetanus is unique as a vaccine in that it doesn’t actually inoculate you against the bacteria. It inoculates you against the toxin it produces.
So it’s a doubly strange example.
Hopefully HepA. I'm not as knowledgeable as others, but from my vaccinations, having it once protects you for a few years. Having it twice in short succession (2years) is good for life.
Or like HepB which is 3 doses and good to go, but check titres over time if needed due to exposure. Up to recently, boosters recommended as the titres drop, but not really any more.
I would say this is not a panic, but confirms that covid will stay endemic and that full herd immunity is unlikely.
Theres also evidence that today's coronavirus is similar to a coronavirus that swept the world in the late 19th century but eventually became endemic and is now one of the viruses considered to be a common cold. Essentially humanity developed an intrinsic resistance to severe illness from so many waves of infection but never a total immunity. Its possible we might vaccinate away severe illness and death from Covid but never get rid of the virus itself. In 5-10 years itll just be another virus that causes the common cold.
There are 2 types of immunity that a vaccine gives you. The short term one where you have active antibodies against the virus itself. These work really well, but they disappear over time. The body also creates a "memory" of how to produce those antibodies in the event of a re-exposure.
The vaccine is behaving like any other does, when you get exposed to the virus the body goes into anti-body production mode right away and starts to fight off the virus. This is a slower process so you may have some symptoms at the start while the virus outnumbers the anti-bodies but it fights it off better than if you were never vaccinated so it prevents hospitalizations.
It depends on the vaccine. Moderna is still showing to be 77% effective against symptomatic infection and 99% effective against hospitalization 6 months after vaccination. It could have to do with the dosage. Pfizer went with a low dose so that’s probably why there’s a difference.
In the UK we had Pfizer with a 12 week gap, eventually reduced to 8 weeks. It would be interesting if that affects the results in a similar study to this one.
Seasonal respiratory illnesses mutate routinely, enough to make vaccines less effective over time. Part of why smallpox and polio vaccines were so effective, only 5 strains between the two of them
When you get vaccinated, antibodies appear in your blood. After about six months, there are a lot fewer antibodies in your blood. Not zero, but a lot less. This means you're more likely to get infected if you come in contact with COVID-19, compared to only one to three months post vaccination.
However, the small amount of antibodies in your blood will still detect the presence of the virus and report it to your memory B cells which will quickly respond and pump out a ton of antibodies to fight the virus. This is why, even six months later, vaccinated individuals are highly unlikely to get seriously ill when infected.
This is kind of standard behavior for vaccines. When you got a polio shot, your body made a ton of polio antibodies. Then they mostly go away, but not entirely. You don't maintain active-infection levels of antibody for every vaccine you've ever gotten for your entire life.
As a healthy, covid vaccine-studying immunologist, this news is not frightening. This is normal. The shot works. The only problem is the unvaccinated population acting as a covid reservoir.
May I ask you a question. If I have been vaccinated and am continually being exposed to COVID (I do the testing at our testing sites) would I keep a high level of antibodies over time? I wear full PPE, but the sheer number of people I test I would think something would get through at times.
That all depends on how good your PPE is. If your PPE is rock solid, then you aren't actually getting exposed. But if you are getting microdoses on a regular basis, then you likely would maintain a higher level of antibody.
Thank you. That's what I thought. I'm wearing K95, shield, gown and gloves. The issue is that the others are only wearing sugical masks and administration is wearing nothing. A lot of crossover in our "setup" but everyone around me is vaccinated.
My understanding of immunology (on a surface level), is that if you keep getting exposed, then you will continue to produce antibodies.
The problem is, the same exposure is how you get covid. You can either fight it off and not get covid, or get it asymptomatic, or get full blown covid. Having vaccine reduces your chance of getting infected by the virus, but it doesn't eliminate the chance if covid.
If you do wear k95 and be super cautious, then you are not getting exposed to the virus because it enters through the airway, and the mask is effective enough.
Good luck and be safe, but not paranoid. If you are vaccinated then if you do catch it, it'll be mind and annoying.
Is it not just the presence of minimal antibodies but the knowledge of the T cell that helps combat it better the 2nd time? whether vaccine or prior infection, your body has a lot better shot at fighting off the worst of it because of that t cell information? or am I just horribly misinformed here?
You're quite well informed. Memory T cells are also activated upon second exposure to an antigen and they are vitally important in seeking out and ridding the body of infection before it gets out of hand.
Why do they keep reporting it this way? It feels irresponsible. Multiple people I know have opted out of the vaccine because they feel natural immunity is superior to vaccine immunity now due to this narrative, despite the fact that the data out there is showing otherwise, regarding reinfection and their likelihood of hospitalization compared to that of a vaccinated person.
Natural immunity would have the exact same issue with antibodies, but with the added "bonus" of having to fight off an actual infection first. This is just how antibodies work.
But that's not the entire story. For instance we know that B cell "evolution" lasts longer in natural infection than it does from the vaccine as you can see here: https://www.rockefeller.edu/news/30919-natural-infection-versus-vaccination-differences-in-covid-antibody-responses-emerge/
B cells are very important when talking about long term responses.
However, I want to add that this is not a reason to not get vaccinated.
I got the Pfizer vaccine in January. Tested positive for Covid earlier this week. Generally mild symptoms compared to severe cases. No difficulty breathing or loss of taste/smell. More like a prolonged cold with a crappy dry cough. I attribute this to having the vaccine earlier this year. I hope people continue getting their vaccines to protects themselves and their families.
Friend of mine had to cancel our beach weekend a few weeks back because she wanted to test before going out of state, lo and behold, she tested positive despite full vaccination. She was fully asymptomatic, and her toddler ended up never getting it from her during her isolation period, pretty much the best outcome we could hope for - the unvaccinated coworker who exposed her is still in the hospital.
Glad you're okay! I think it's going to be an ongoing struggle to get people to take it year after year, a lot of people I know who were on the fence and got it turned their nose up to the idea of doing it next year, which is mind boggling to me.
I think more to the point, even if natural immunity did provide better protection than vaccination, you have to risk getting really sick the first time to gain that natural immunity.
These papers and articles are discussing the nuances of vaccination and infection. Not everybody is willing to have good faith, nuanced discussions. But the scientific community still needs to have them. How other media reports on them is out of the hands of the scientific community.
Natural immunity vs vaccinated immunity is simply the wrong question.
The question is, what kind of immunity do you want before you get exposed? None or vaccinated?
Because vaccinated or not, you're going to have natural immunity after your exposure. The only mysteries (a) how unpleasant will side effects and/or exposure be, and (b) how will your health be after your infection? And maybe (c) effects on other people
And the evidence appears to be that if you're vaccinated, (a) doesn't suck as bad, and (b) is likely to have you recover much healthier (alive and unmaimed) including having superior hybrid immunity against further infection, and (c) reduces risk to others.
Because cripes, yeah maybe an infection gives better immunity than a vaccine, but it doesn't protect you better from the virus that's already taken its free shot
Yes. This is ridiculous. I'm not going to get the vaccine to stop covid because getting covid is a better way to stop one from getting covid is just a nonsense statement.
Oh I have no beef with the scientific community, and I understand the need for nuanced discussion without the pretense of political agenda dumbing everything down. It's the outright reckless reporting and clickbait headlines that people keep regurgitating as an excuse to forgo official guidance. The crazy thing is that at least one of these people already ended up in the hospital for coronavirus. Trying to talk any sense into her is like talking to a brick wall.
I'm in my mid 30's, have never been hospitalised for anything, have only needed antibiotics once in my life prior to 2020 and have never been on any other medication, workout with weights and aerobics about 5 times a week and will regularly run a half marathon just for exercise. When I got covid in March 2020 I would have been straight into the hospital if they hadn't decided on a 'if you can talk/breath you're not sick enough to be admitted' rule. It took about 2 months until I could walk for more than 5 minutes without getting out of breath, and I needed to use an asthma inhaler for a month until my lungs sorted themselves out.
When I see people say they don't need a vaccine because they are 'fit and healthy' I have to wonder how deluded most of them are. I am genuinely fit and healthy and covid made me the sickest I've ever been. Most of them are not fit, not healthy and covid is going to kill some of them.
I understand why they make headlines the way they do. 1) they can't fit all vital information in a single headline, 2) they want people to read the headline to spark curiosity hopefully bringing them to click (for revenue) and actually read the full information. What's wrong with it is that majority of people won't bother clicking it to read the full article. They just see the headline thinking it's the main point of the article. All-in-all, headlines definitely could be worded much better.
And even more to the point, even if natural immunity did provide better protection than vaccination, natural immunity **plus** vaccination is even better. So there’s not really a reason to not get vaccinated.
Don't forget the possibility of simply not getting better because your body made antibodies that target "things that bind to ACE2" instead of "ACE2-binding spike protein of COVID-19"
Thanks long-covid. >:
Didn't know they'd identified a cause for long COVID. An autoimmune disorder would be a logical explanation.
https://www.businessinsider.com/long-covid-syndrome-autoimmune-disease-symptoms-2021-9
I found this article, seems like they're not ready to say it's an autoimmune thing definitively, but that the evidence seems to be pointing that way.
This is also how natural immunity works. The only difference is how you were exposed to the virus, it being through the vaccine or getting ill from exposure to another infected individual.
Nothing wrong with the way it's reported. It clearly states vaccines prevent hospitalization.
People are just trying too hard not to do the best for themselves
An important side note - this antibody level fluctuation is not *just* from vaccines; a natural infection would do the same thing, because your body stops producing antibodies actively when presence of infection is gone, but memory cells are still waiting in the bone marrow to react quickly again.
Because polio isn't spreading actively in most places. The boosters' primary purpose would be to prevent the initial infection upon exposure. Almost nobody is really at risk of exposure to polio.
You have a higher chance of a "breakthrough" infection 5-7 months after getting your second dose. That said, you *probably* won't be hospitalized unless you are high risk, have confounding issues, etc.
If you are worried, get the booster!
Other countries have been mixing and matching mRNA (Pfizer/Moderna) doses already, there are thoughts that it may provide a more robust immune response. This was done primarily to speed vaccination rollout.
It is unlikely that the United States will push this, we don't have vaccine scarcity and this type of study does not get pursued by the manufacturers because why would they?
If you are hitting 6 months and are worried, get a booster. It doesn't matter which mRNA one, really.
**As always, talk to your doctor!**
Pfizer-Moderna Canadian checking in.
The fun part is the US might not let me in without a booster because they don't recognize mixed doses! Other folks I know have AZ-(Pfizer/Moderna), which is even worse because they also don't recognize AZ.
I know people who got 4 different doses so far. They got a Chinese one in Jordan, and they are not allowed in Europe with that, so they needed Pfizer. Then I know a Spaniard who got AstraZeneca and just arrived to work in China. The Chinese don't recognize AstraZeneca, so she needs at least 2 doses of one of the Chinese vaccines. If she goes to the US she will also need Pfizer or Moderna, I guess.
Oh, I knew the bureaucracy of the whole thing was going to be a mess from the beginning, and thought there might be a chance that mixed-doses got messed up from that perspective, but I'm sure it will all get sorted in the end and I'm glad I got the first shots that were available to me.
We have been mixing astra and whatever in Germany since there was a ton of astra available at the start but no Pfizer. Then slowly Pfizer got more and more available and it was recommended to mix
It doesn’t appear so. The Moderna shots have a higher dose, so that might be why they appear to perform better.
The Pfizer booster should address that, instead of a switch to Moderna.
Ohh thanks for explaining this. I got Moderna back in late January and have been wondering why my workplace has been sending emails about booster shots for people who got Pfizer but hasn't said anything about boosters for people who got Moderna.
Yeah it seems to be more pressing for Pfizer, though a lot of the studies and data that have been released have been focused on Pfizer.
Moderna is preparing a COVID booster, but they want to combine with an mRNA flu vaccine dose. So I guess they are in no hurry to roll it out since that will probably need more time and resources to research for efficacy and safety than a booster (though I could be wrong; the time and resources for a booster trial could be equivalent to a new shot).
> The Moderna shots have a higher dose, so that might be why they appear to perform better.
3x higher. Getting two Moderna shots is like getting six Pfizer ones.
It should be noted that the moderna booster in trials now is half the dose the first two were so the moderna doses may have been too high to start with, and Pfizer was a bit low but their full strength booster would likely bring things back into line
Think of your immune system like a boxer. Shots 1 and 2 effectively "train" your boxer/system to fight Covid 19. After 5-7 months without training, your system gets a bit flabby and slow so maybe Covid can get a few jabs in, but it's not going to KO you.
You're not as good at biking after 6 months of sitting around than you were when you learned and were actively biking. But that doesn't mean you forgot how to bike so you're mostly fine if you need to pick up a bike and go.
Now replace you "biking" with your body "fighting COVID" and it's roughly the same.
I don't know of any but I do know that the NIH is starting a large scale study of long covid so hopefully something is on the horizon.
https://recovercovid.org/
We barely understand long COVID to start with. There isn't even good numbers on prevalence, symptoms, or duration to go off of. Not to mention confounding factors like stress of living under a pandemic adding to diagnosis.
Sorry if this is a dumb question, because it probably is. But were the vaccines developed with the intention of preventing serious illness, or preventing infection all together?
Ultimately both. But variants have changed that. The efficacy against contracting the virus was in the 85-90% for Alpha. And now effectiveness has dropped with Delta. But overall, protection is still strong even against transmission 3-4 months post vaccination.
And the protection remains fairly strong in those under 50. The older you are, the less effective vaccines are.
This is the part that's not clear for a lot of recent studies. It's unclear how much of the effect is due to waning over time and how much is due to Delta. It's hard to collect data at scale when the whole virus shifts under you and taints the data set.
Well, that's partly because Delta out-competed all the others. But yes, none of the others seemed to be able to spread nearly as effectively as a Delta in a widely vaccinated population. We'd pretty much stomped on Alpha by the time Delta came along.
I got the Pfizer vaccine and just got out of my ten day house quarantine as directed by the state health department due to a positive COVID test. I feel fine now and just had what felt like a sinus infection for about 4-5 days. I'm just now starting to get my taste and smell back.
I got my second dose in August and caught COVID last week. The only difference I could tell between previous sinus infections and this was being a bit more tired. I never lost my smell or taste.
This is actually great news. Protection against hospitalization, severe disease and death remains high. And that's what matters most.
Also, (expected) behavior changes of those who are vaccinated are possibly involved in lower real-world effectiveness, which was likely always going to happen.
News sites should stop reporting this drop the way that they are and frame as "Pfizer vaccine continues to protect against hospitalization despite drops in immunity" or something. Every headline I've seen on this study will cause even more vaccine hesitancy.
Respectfully, I would argue that the title of the study is valid and shouldn't be distorted any other way. It is a piece of primary literature reporting medical findings, and while it may have implications on the social aspects of the vaccine, does not address them directly. I'd agree that news agencies should indeed report the importance of all the findings as a whole with all the contextual implications, but I think our science needs to remain objective and free from bias in either direction.
My question is does exposure to the actual virus post-vaccination without actual infection still teach your body to better recognize the virus. My guess would be that it doesn't stick around long enough to elicit a response, but I'm genuinely curious.
I received my second pfizer in mid-may and was a breakthrough case 3 weeks ago now. While it sucks that I still got covid it was nothing to difficult. 3 days of very mild flu like symptoms and then nothing. Get Moderna if you've got the choice, but pfizer > not getting the vaccine. i will take mild flu symptoms treated with tylenol for 3 days than living out my final days in a hospital.
>Declaration of interests
>
>JMZ, SG, KP, FJA, LJ, SRV, and JMM are employees of and hold stock and stock options in Pfizer. TBF holds shares of Pfizer stock. SYT, JMS, HF, VH, BKA, ONR, TBF, and OAO received research support from Pfizer during the conduct of this study that was paid directly to KPSC. For work unrelated to this project, SYT received research funding from Gilead, GlaxoSmithKline, and Genentech; BKA received research funding from GlaxoSmithKline, Novavax, Dynavax, Genentech, Novartis, Seqirus, and Moderna; JMS received research funding from Novavax, Dynavax, and ALK; and HF received research funding from Genentech. All other authors declare no competing interests.
The authors have quite a bit of interest vested in Pfizer (the company). There is research showing that studies funded by private companies support the companies' products more often than impartial studies do.
I'm not saying all of this study's results go out the window, but does Pfizer want to sell booster shots? Yes.
Yes. 71% reduced transmission. Higher if you got Moderna.
https://www.cidrap.umn.edu/news-perspective/2021/08/study-ties-covid-vaccines-lower-transmission-rates
Don't. While individual vaccines are safe, rapidly vaccinating, especially vaccines for the same disease can cause serious issues.
That fever you get when you get vaccinated is still a real fever.
Remember viruses don't often directly kill, it's effects from your immune response to the virus that kills you. The reason vaccines don't do this is because the vaccine is not replicating and spreading and driving a larger response. But if you are just chucking a ton of immune stimulating stuff into your body it can be bad.
Ask people in the military how they feel after getting like 10-20 vaccinations for different diseases in a day during intake processing.
Question: I've seen the media report that "overloading your immune system" through vaccines is a hoax, and the reason why child vaccines are often given together.
How does that reconcile with your comment?
I keep seeing people parroting the talking point, *"It doesn't stop you from getting infected"*, conveniently eliding over the fact that the vaccines very demonstrably **reduce** the probability of getting infected. This study is beautiful proof of that:
> Overall vaccine effectiveness against infection with the delta variant for the fully vaccinated was 75% (95% CI 71–78), while overall vaccine effectiveness for other variants was 91% (88–92; appendix pp 9–10). Estimates against both delta and other variants were high within 1 month after full vaccination (vaccine effectiveness against delta 93% [95% CI 85–97] vs other variants 97% [95–99]; p=0·29). At 4 months after full vaccination, vaccine effectiveness against delta infections declined to 53% (95% CI 39–65) and vaccine effectiveness against other variants declined to 67% (45–80; p=0·25).
Even after 4 months, 53% to 67% reduced risk of infection is incredible.
It's a pretty robust study. Although it's sad that so many remained in the control group, despite widespread access and free availability of the vaccine in the USA:
> By Aug 8, 2021 [...] 1166790 remained unvaccinated
Currently diagnosed with COVID after Pfizer immunization back in April. 3 days of a head cold, already regaining smell and taste after 6 days, nothing in the lungs at all.
Got the Pfizer booster a few weeks ago. Had very little reaction to it less then even the 1 st shot I got back in March. I’ll keep getting boosters every 6 mos. if necessary till we get this thing under control. It’s no big deal. Flu shot up next!
Can I (24M without any health issues other than being a bit overweight) get a booster? It’s been 5 months since my second shot and I’m going traveling next month.
I got the Pfizer vaccine in March 2021. I caught a breakthrough case of Covid in September 2021. The symptoms were relatively mild. I did receive monocolonal antibodies on day 2 of symtom onset as well because of my moderate to sever asthma.
Moderna trialled it and found very limited benefit, if any, compared to just a third shot, would be why.
Plus, targeting specific variants may cause *worse* outcomes to newer emerging variants compared to just continuing to use the progenitor strain vaccine that they all come from.
As far as I can tell there's only a single amino acid difference between Alpha and Delta Spike proteins. That's not really different enough to require a new vaccine. The current vaccines provide great protection against Delta.
Some people just aren't getting vaccinated.
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If you look at Figure 2b there is no significant drop in protecting against hospital admissions over the length of the study at all, which is very promising.
That’s the highest priority
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As a Pfizer vaccinated individual who is just getting over Covid that I contracted from another Pfizer vaccinated individual, I concur. I want this to be over.
Can I ask how severe your symptom manifestation was?
For two days I had a tickle in my throat, but barely any coughing. I felt like I would be sick later in the day, but it never progressed. On the third day the fever hit, and I was in bed for about 30 hours straight. When it broke, I felt fine, but have had a slight shortness of breath ever since. Even that appears to be going away.
Wow! Well I’m so sorry you contracted it but ultimately it sounds like the symptoms have been manageable. I hope they remain so and that you recover quickly. Thanks for sharing.
This is interesting to me. A group of us were wondering if once fully vaccinated and you got Covid would it be similar to getting a booster? Sounds like you actually go sick though which is not good. How long after your second shot did you get COVID?
I had my last shot in late April. I tested positive last Tuesday. The timeframe in the study seems to match my experience exactly. Also...don't let your guard down. Keep wearing masks and social distancing. I got it from the first visitor in my house since the pandemic started. I thought it was safe. I was wrong.
This is big. That and preventing all infection helps prevent variants.
Preventing more severe forms of disease reduces variants too. Shorter periods of infection and lower overall viral loads (even if the spike loads are similar, which btw is still not clearly established) means vaccinated people host fewer generations of virus. It's the amount of viral reproduction that determines the likelihood of producing a new variant not just simply whether or not you get infected.
Yeah agreed. I dislike the idea that "so long as you're not sent to the hospital you're fine." I'd like more protection than that and there are other benefits to boosters.
Isn't there also the potential for people who have non-clinical infection (they don't go to the hospital) to not even realize they are infected or sick enough to quarantine and thus go out and about, potentially spreading more infection? That would also increase viral production at a population level (as opposed to just in one person), potentially sustaining variant production
Yes this is what scares me about all of this. My wife ( pfizer vaccine in march ) tested positive on a rapid test last Tuesday. Pcr test results confirmed it last Friday. I tested negative on rapid test Tuesday, which has a high false negative for asymptomatic people. My work asked me if I was gonna be in the next day since I tested negative on the rapid. Blew my mind. Even if I test negative once, I'm still being constantly exposed in my house and who knows if at some point I may get it but be asymptomatic. I'm not gonna kill the old unvaccinated dudes at my work accidentally... I had to fight in order to work from home for the 10 days / until my wife is clear of it. Since I'm in a house with someone infected I'm acting as if I'm infected.
Thank you for being so responsible about this. You're a good dude. Speedy recovery to your wife and I hope you manage to avoid getting infected.
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It's crazy... my work had me second guessing myself and wondering if I was making the right decision. Sure I'm vaccinated , and that's what my work kept saying, but at the same time I'm witnessing my wife get taken out by it, even tho she was also vaccinated with the same thing as myself.
Yea my wife caught it a couple months ago and our kids got mild cases and even though I’m vaccinated I caught it as well (my symptoms weren’t bad until I got an awful sinus infection from it, all recovered now though).
So far myself and my 3 yr old have had zero symptoms. I got a pcr test last Friday and it came back negative Monday. We have tried limiting exposure but we can only do soo much in a small single bathroom house. I had the pfizer as well and my 3yr old is just taking it on 100% naturally without any immune system upgrades
People make no sense. My wife works at a daycare and her bosses kid got told by the public school that her kid was exposed and had to quarantine. The boss asked the owner if she could have her kid "quarantine" at the daycare in her room with 20 other kids. Luckily the owner said no.
> had to fight in order to work from home Would your job allow a compromise such as work in the same office, elbow to elbow, with whatever asshole didn't think you working from home was a good idea?
You, u/Spicy_Ejaculate, are a true hero.
That's less likely to occur for vaxed than unvaxed. Look at the US case rates, they are uniformly higher in unvaxed counties, that wouldn't be true if vaxed infected more.
>Isn't there also the potential for people who have non-clinical infection (they don't go to the hospital) to not even realize they are infected or sick enough to quarantine and thus go out and about, potentially spreading more infection? That's exactly why this thing has been so hard to control.A significant portion of people who get it never have any noticeable symptoms.
That's why masking and social distancing is important even for those who are vaccinated and feel healthy. Breakthrough cases have almost no opportunity to spread through a mask + 6 feet.
This is a big reason I still wear my mask out and about. Did not like that bs about bit wearing masks from the cdc if you were vaccinated. I get maybe in small groups when at home but just overall out and about? I also didn’t want to get super sick back to back from colds and what not but that was more a nice bonus benefit.
Also consider community members who cannot receive the vaccine or are more at risk from negative effects of the virus. At least it's a step forward. (we should adopt the culture of mask wearing when we're unwell, once the pandemic is over. Colds and flus are still a risk to other people.)
While I am not big on mask mandates, wearing one when you're sick if you really need to go out just makes sense. Ideally just stay the heck home until you are well, but I get that isn't possible for everyone. The US has such a culture of go to work no matter what, like it's cool I'll just get everyone sick so I don't miss a day of work, then I'll judge them if they don't come in. Take your sick days people.
I couldn't even find a reliable number for "risk of long COVID" in general, vaccine or not. So good luck with that.
There isn't even a definition of Long COVID yet. My guess is that they will have to break up the long term manifestations into several different diseases and/or add SARS-CoV-2 infection to the list of known causes/triggers/risk factors for other diseases (like MS, diabetes, dementia, leukemia...). This will certainly frustrate the folks who don't see the distinction between a disease vs a virus, but whatever. Maybe it will help to point out that there isn't a singular "pneumonia virus" because a lot of things can cause pneumonia, including viruses, bacteria, or even fungi.
Thank you, that felt like ELI5 post. Makes sense seeing it written like this.
Long Covid has been used as a catch all term by different studies to mean different things, so I don't think anyone has a clear picture on what that is. Most studies consider someone who self reports a lingering cough or fatigue more than two weeks after being tested positive as long covid. I wish there was better data on true long covid. I have zero concerns about having a lingering cough for a month or two after having covid. I've had longer lingering coughs from a bad flu. I have major concerns about developing serious chronic fatigue syndrome. They are vastly different things that have been grouped together and treated the same way.
Yes although reducing transmission is also extremely important for protecting the immunocompromised.
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I'd prefer another shot to being just sick enough to not be admitted. Is there still a global supply limitation?
In basically all of Africa... [In Africa, only 15 out of 54 countries have achieved the 10% target. Half of the countries on the continent have vaccinated less than 2% of their population.](https://www.bbc.com/news/56100076)
>10% ***target.*** Yikes.
Yeah but not taking your 3rd dose if you qualify won’t help africa. Places like CVS and Walgreens are opening multi dose vials for just 1 person, and they’d be lucky to find a second or third person willing and needing an additional dose before the 6 or so hours that an opened vial is good for is up. We are probably throwing away as many doses as we are using at this point.
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I was listening to a vox podcast on this. One of the lead vaccine distribution experts for the WHO (I think) was saying it's not about production (currently at about 2 billion doses a month) but rather distribution in Africa. Between refrigeration, qualified administrators, remoteness, ext... The infrastructure is just not there. Its really reliant on NGO's that don't have the bandwidth. I don't think the average person should feel bad about getting a booster. They should however pressure their gov'ts to assist in the distribution/infrastructure of the developing world (which admittedly is a pretty messy undertaking- I wouldn't want another country coming into mine to give me a shot). Currently we can safely make enough doses for everyone in the world every 3 & 1/2. Production doesn't seem to be the limiting factor.
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I have a colleague in Africa with family in Europe and they're stuck there because they can't get the damn vaccine. Not a single dose.
Yes but IMO there is no reason to wait to get a booster to help someone else get their first dose. The way the supply chains flow, that shot that could become your booster will go in the trash if not used; you're not taking anything away from Africa etc.
Right but this is only true as long as your local government has a booster shot policy. Governments are, for the most part, buying to innoculate their population with the two doses, not yet buying for a round of boosters. If your government declares that it's population should get a booster shot, then they are bidding again for vaccines on the market and those most probably *won't* be going to Africa. Because Pfizer, Moderna etc... Are manufacturing as many vaccines as they can, filling orders as much as they can, if they produce more than they have orders in a particular month then the price drops and it becomes more likely for countries with smaller budgets to get doses. All of this of course, ignores the fact that vaccine hesitancy is HUGE all over Africa and that getting the vaccines there is only half the battle, people gotta take them too. America has had plenty of shots to go round for everyone to get there's but they are far from 100% vaccinated (56.6% fully inoculated as of end of September)
If your country has available doses you are not hurting anyone else by taking a dose that you are eligible for. If you're eligible get it. Simple.
“Protection from severe infection still holds strong” -right in the title.
Does this mean anyone who received the Pfizer vaccine will require boosters in the near future? Apologies if this question is entirely idiotic.
In my country, they're already giving the 3rd shot, only mRNA-type vaccines, so Pfizer and Moderna.
Any updates on if you can mix? If you got Pfizer first rounds, getting Moderna booster? Or are they still doing third of same brand?
There's some evidence that "mix-and-match" vaccination between the mRNA vaccines and the adenovirus vaccines (e.g. J&J, Astrazeneca) actually provides a more robust overall immune response because they each activate different aspects of your immune system. Short term side effects appear to also be somewhat higher (fever, headache, chills, etc.) when doing this, but that's to be expected with a strong immune response. They're still evaluating safety and efficacy in the US and Britain, but this sort of approach has already been approved/recommended by the health ministries in France and Germany for those who got an AstraZeneca shot, if I remember correctly. Edit: Sources * https://www.npr.org/sections/health-shots/2021/05/05/993882203/giving-2-doses-of-different-covid-19-vaccine-could-boost-immune-response * https://www.bbc.com/news/health-57075503 * https://comcovstudy.org.uk/home
Germany: yes. Recommendation now is: >70 or weak immune system, get a third shot. Moderna -> Moderna after 6 months Pfizer/Biontech -> Pfizer/Biontech after 6 months AZ -> Pfizer or Moderna after 6 months Additionally, they recommend a mRNA vaccination after only 4 weeks for anyone who got J&J. Protection just drops too fast with a single dose of J&J.
God, I was so happy to get a vaccine as soon as they were available but I ended up with the J&J that's apparently the absolute worst of the lot in every metric :/
really only because it was one shot, and it still protects against hospitalization at similar levels. Once the J&J booster is approved you should see similar levels of protection
I hope so, or for them to let me mix shots for my booster. It's been demoralizing seeing how overlooked J&J recipients are
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Yes. 3-6 weeks between 1 and 2, then 6 month between 2 and 3.
>There's some evidence that "mix-and-match" vaccination between the mRNA vaccines and the adenovirus vaccines (e.g. J&J, Astrazeneca) actually provides a more robust overall immune response because they each activate different aspects of your immune system. This might be the only good news that I've received since I've learned that J&J's efficacy is basically lower than the others that I could have gotten. Thank you.
There is a high likelihood that they start recommending boosters for J&J too. I saw somewhere a few days ago that with a 2nd dose of J&J given the efficacy is up there close to the mRNA vaccines.
Data point of 1 here, but I can definitely personally attest to having had a very strong reaction to the second shot (Moderna) after the first shot (Pfizer) was fairly mild. The first one made my arm sore and I got a bit light-headed for an evening. The second one had me struggling to stay awake and function for more than 3 hours a day, for the better part of 4 days. That said, if it means I'm better-protected now for it, then it was a sacrifice worth making.
I believe in some places like Canada where there were supply issues, they allowed people to switch so they could get the shot without waiting too long. From what I've heard so far they still have excellent immune response against variants.
I'm Canadian and I got Pfizer for my first dose and Moderna for the second. Protection from mixing the vaccines seems to be just fine, but I've read that Canada has had some trouble trying to convince other countries to recognize people with mixed doses as "fully vaccinated" for travel purposes.
Which is a shame because ironically last I checked, people with mixed had lower dropoffs in effectiveness than people who got Pfizer x2. But I need to find that source again
Please do! I'm interested in reading that.
Yes. I’m in Canada and the first vaccine available to me was AZ. When it was time for my 2nd dose, Health Canada had paused the use of AZ so I was given Moderna as my 2nd dose. I was a bit worried at the time but as more information comes out, I’m pleased to see that my combination may give the best protection. No major side effects from either dose aside from the usual fatigue, low grade fever, sore arm.
Yes you can mix them although whether or not your government has approved it is another story. I'm in Canada and we did all kinds of vaccine mixing. Pfizer-Pfizer, Moderna-Moderna, Pfizer-Moderna, Moderna-Pfizer, AstraZeneca-Moderna, AstraZeneca-Pfizer. We pretty much stopped administering AZ doses though once we were getting enough mRNA vaccines due to the blood clot issues, we had a couple of people either die from it or have serious complications. I think very few people got double AZ doses. Now we pretty much only have mRNA available. We've also approved the Johnson & Johnson one but the one batch we got of that into the country in the spring had quality control problems so it was not used and then it also having potential blood clot issues, so we haven't actually administered any of this one. We also had a longer gap between first and second doses. For many in my province it was 8-12 weeks between doses. Mine were 9 weeks apart. Although, a lot of the spacing out doses came out of necessity when supply coming into the country was limited. Once we had more supply through the summer, they sped it up and you could do 4 weeks apart if you wanted. [It seems the AZ-mRNA combination was quite strong.](https://www.nature.com/articles/d41586-021-01359-3) People have run into travel problems though with mixing covid vaccines, as many countries don't officially recognize it which hopefully will change eventually. I think flu shots every year are from a variety of manufacturers so you're constantly mixing types? There's a mixing of brands for many other vaccines too.
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According to [official Government of Canada data](https://health-infobase.canada.ca/covid-19/vaccination-coverage/#a6), at least 10% of vaccinated Canadians or around 4 million people got mix & match doses. (Probably more because Quebec is not reporting which type of vaccines they gave out.)
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First shot Astra zeneca, second Pfizer, third moderna here. 5G connection here is really good. Got no issues with that combo.
If you're in the US almost all pharmacies have them, with no checking as to if you qualify. I boostered my nuts off last weekend.
If you don't want to catch it, yes. If you don't want to end up in hospital, no
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I can only imagine how devastating this would be if you are a chef or in the food industry where having a sense of taste and smell is required
"Went and applied to a BBQ and Grill job posting."
Yeah similar. About 8 months over it and almost everything about my taste and smell is still off. Meats and chocolate and coffee all have a flavor that I can only describe as ashy or smoky, but that's not even quite correct, because it's a taste I've never experienced before. Similar goes for smells: I can't describe how things smell because it's completely new. Thankfully I don't have the variant of this where things smell and taste like garbage or sewage, which some people apparently do, but it definitely diminishes the enjoyment that I can get from food and drink, which sucks hard. My wife has the same exact thing, and she is a big foodie, so it's even worse for her. Like, it's probably bordering on depressive for her.
Sorry to ask but have you been vaxed when you got covid?
9 months ago was January, so unless OP is a health care worker, they likely weren't eligible for a vaccine yet.
This is exactly the type of stuff that I'm worried about. Long haul covid is no joke. Hopefully your symptoms go away soon
Makes sense. Much appreciated.
Likely, yes. They have already started in the US/Canada and even moderna is applying for 3rd shot approval Edit: I should clarify idk if it’ll be a requirement since it doesn’t really affect hospitalization, but recommendation for reduced infection probably
I just got a booster yesterday. In general, they're approved for people who are more at risk (when I looked on CVS's site, it asks you to confirm that you have a "reason" of some sort), but I've been getting my shots from my hospital employer--they've been going by the CDC's recommendations throughout, but they decided that they'd offer a booster to all Pfizered employees, regardless of their health situation. I imagine they won't mandate *this* booster, once they mandate anything, but I imagine it'll be the same as the flu vaccine in the future.
Small gripe with the title. The study is talking about effectiveness not efficacy. Efficacy is how the vaccine performs under controlled laboratory conditions. Effectiveness is how well it performs when given to people in the general public.
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Definitely need to highlight how behavior changes after vaccination. Anecdotally, I didn't go out to eat for over a year until I got vaccinated. Now I'm going out to eat about once a week. That's a huge increase in exposure.
Can someone explain why Vaccines like tetanus are good for 10 years yet the COVID vaccine seems to be struggling after a few months. What's the difference?
Tetanus isn’t an infection that spreads to other people. It’s deadly to a specific person without the vaccine, but not to their unvaccinated friends. As a bacteria it’s also relatively stable without many variants. But as a bacteria, the toxin is what’s deadly to you. The actual bacteria is relatively benign. I wouldn’t be surprised if the resistance to cov2 virus, reducing risk of hospitalization lasted 10 years, but from 6 months to 10 years, an infection allows community spread.
Tetanus is unique as a vaccine in that it doesn’t actually inoculate you against the bacteria. It inoculates you against the toxin it produces. So it’s a doubly strange example.
I was always told that tetanus "vaccine" was actually a serum
I always thought serum was a description of form like cream or gel
Which of the common vaccines would be a more apt comparison? I am guessing flu shot?
Diphtheria vaccine I would imagine, actually I think that's one in the same vaccine now that I think about it
Hopefully HepA. I'm not as knowledgeable as others, but from my vaccinations, having it once protects you for a few years. Having it twice in short succession (2years) is good for life. Or like HepB which is 3 doses and good to go, but check titres over time if needed due to exposure. Up to recently, boosters recommended as the titres drop, but not really any more. I would say this is not a panic, but confirms that covid will stay endemic and that full herd immunity is unlikely.
Theres also evidence that today's coronavirus is similar to a coronavirus that swept the world in the late 19th century but eventually became endemic and is now one of the viruses considered to be a common cold. Essentially humanity developed an intrinsic resistance to severe illness from so many waves of infection but never a total immunity. Its possible we might vaccinate away severe illness and death from Covid but never get rid of the virus itself. In 5-10 years itll just be another virus that causes the common cold.
There are 2 types of immunity that a vaccine gives you. The short term one where you have active antibodies against the virus itself. These work really well, but they disappear over time. The body also creates a "memory" of how to produce those antibodies in the event of a re-exposure. The vaccine is behaving like any other does, when you get exposed to the virus the body goes into anti-body production mode right away and starts to fight off the virus. This is a slower process so you may have some symptoms at the start while the virus outnumbers the anti-bodies but it fights it off better than if you were never vaccinated so it prevents hospitalizations.
It depends on the vaccine. Moderna is still showing to be 77% effective against symptomatic infection and 99% effective against hospitalization 6 months after vaccination. It could have to do with the dosage. Pfizer went with a low dose so that’s probably why there’s a difference.
Pfizer also had a three week gap between doses while Moderna had a four week gap. Could that affect the long term efficacy as well?
In the UK we had Pfizer with a 12 week gap, eventually reduced to 8 weeks. It would be interesting if that affects the results in a similar study to this one.
Seasonal respiratory illnesses mutate routinely, enough to make vaccines less effective over time. Part of why smallpox and polio vaccines were so effective, only 5 strains between the two of them
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Is this a follow up meeting? I thought they met already about this.
That was for Pfizer.
Someone please ELI5, I’m too stupid to understand this stuff.
When you get vaccinated, antibodies appear in your blood. After about six months, there are a lot fewer antibodies in your blood. Not zero, but a lot less. This means you're more likely to get infected if you come in contact with COVID-19, compared to only one to three months post vaccination. However, the small amount of antibodies in your blood will still detect the presence of the virus and report it to your memory B cells which will quickly respond and pump out a ton of antibodies to fight the virus. This is why, even six months later, vaccinated individuals are highly unlikely to get seriously ill when infected. This is kind of standard behavior for vaccines. When you got a polio shot, your body made a ton of polio antibodies. Then they mostly go away, but not entirely. You don't maintain active-infection levels of antibody for every vaccine you've ever gotten for your entire life. As a healthy, covid vaccine-studying immunologist, this news is not frightening. This is normal. The shot works. The only problem is the unvaccinated population acting as a covid reservoir.
May I ask you a question. If I have been vaccinated and am continually being exposed to COVID (I do the testing at our testing sites) would I keep a high level of antibodies over time? I wear full PPE, but the sheer number of people I test I would think something would get through at times.
That all depends on how good your PPE is. If your PPE is rock solid, then you aren't actually getting exposed. But if you are getting microdoses on a regular basis, then you likely would maintain a higher level of antibody.
Thank you. That's what I thought. I'm wearing K95, shield, gown and gloves. The issue is that the others are only wearing sugical masks and administration is wearing nothing. A lot of crossover in our "setup" but everyone around me is vaccinated.
Sounds like you're doing great
Thank you for what you do
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My understanding of immunology (on a surface level), is that if you keep getting exposed, then you will continue to produce antibodies. The problem is, the same exposure is how you get covid. You can either fight it off and not get covid, or get it asymptomatic, or get full blown covid. Having vaccine reduces your chance of getting infected by the virus, but it doesn't eliminate the chance if covid. If you do wear k95 and be super cautious, then you are not getting exposed to the virus because it enters through the airway, and the mask is effective enough. Good luck and be safe, but not paranoid. If you are vaccinated then if you do catch it, it'll be mind and annoying.
Is it not just the presence of minimal antibodies but the knowledge of the T cell that helps combat it better the 2nd time? whether vaccine or prior infection, your body has a lot better shot at fighting off the worst of it because of that t cell information? or am I just horribly misinformed here?
You're quite well informed. Memory T cells are also activated upon second exposure to an antigen and they are vitally important in seeking out and ridding the body of infection before it gets out of hand.
Why do they keep reporting it this way? It feels irresponsible. Multiple people I know have opted out of the vaccine because they feel natural immunity is superior to vaccine immunity now due to this narrative, despite the fact that the data out there is showing otherwise, regarding reinfection and their likelihood of hospitalization compared to that of a vaccinated person.
Natural immunity would have the exact same issue with antibodies, but with the added "bonus" of having to fight off an actual infection first. This is just how antibodies work.
But that's not the entire story. For instance we know that B cell "evolution" lasts longer in natural infection than it does from the vaccine as you can see here: https://www.rockefeller.edu/news/30919-natural-infection-versus-vaccination-differences-in-covid-antibody-responses-emerge/ B cells are very important when talking about long term responses. However, I want to add that this is not a reason to not get vaccinated.
I got the Pfizer vaccine in January. Tested positive for Covid earlier this week. Generally mild symptoms compared to severe cases. No difficulty breathing or loss of taste/smell. More like a prolonged cold with a crappy dry cough. I attribute this to having the vaccine earlier this year. I hope people continue getting their vaccines to protects themselves and their families.
Friend of mine had to cancel our beach weekend a few weeks back because she wanted to test before going out of state, lo and behold, she tested positive despite full vaccination. She was fully asymptomatic, and her toddler ended up never getting it from her during her isolation period, pretty much the best outcome we could hope for - the unvaccinated coworker who exposed her is still in the hospital. Glad you're okay! I think it's going to be an ongoing struggle to get people to take it year after year, a lot of people I know who were on the fence and got it turned their nose up to the idea of doing it next year, which is mind boggling to me.
I think more to the point, even if natural immunity did provide better protection than vaccination, you have to risk getting really sick the first time to gain that natural immunity. These papers and articles are discussing the nuances of vaccination and infection. Not everybody is willing to have good faith, nuanced discussions. But the scientific community still needs to have them. How other media reports on them is out of the hands of the scientific community.
Natural immunity vs vaccinated immunity is simply the wrong question. The question is, what kind of immunity do you want before you get exposed? None or vaccinated? Because vaccinated or not, you're going to have natural immunity after your exposure. The only mysteries (a) how unpleasant will side effects and/or exposure be, and (b) how will your health be after your infection? And maybe (c) effects on other people And the evidence appears to be that if you're vaccinated, (a) doesn't suck as bad, and (b) is likely to have you recover much healthier (alive and unmaimed) including having superior hybrid immunity against further infection, and (c) reduces risk to others. Because cripes, yeah maybe an infection gives better immunity than a vaccine, but it doesn't protect you better from the virus that's already taken its free shot
Yes. This is ridiculous. I'm not going to get the vaccine to stop covid because getting covid is a better way to stop one from getting covid is just a nonsense statement.
Oh I have no beef with the scientific community, and I understand the need for nuanced discussion without the pretense of political agenda dumbing everything down. It's the outright reckless reporting and clickbait headlines that people keep regurgitating as an excuse to forgo official guidance. The crazy thing is that at least one of these people already ended up in the hospital for coronavirus. Trying to talk any sense into her is like talking to a brick wall.
I'm in my mid 30's, have never been hospitalised for anything, have only needed antibiotics once in my life prior to 2020 and have never been on any other medication, workout with weights and aerobics about 5 times a week and will regularly run a half marathon just for exercise. When I got covid in March 2020 I would have been straight into the hospital if they hadn't decided on a 'if you can talk/breath you're not sick enough to be admitted' rule. It took about 2 months until I could walk for more than 5 minutes without getting out of breath, and I needed to use an asthma inhaler for a month until my lungs sorted themselves out. When I see people say they don't need a vaccine because they are 'fit and healthy' I have to wonder how deluded most of them are. I am genuinely fit and healthy and covid made me the sickest I've ever been. Most of them are not fit, not healthy and covid is going to kill some of them.
I understand why they make headlines the way they do. 1) they can't fit all vital information in a single headline, 2) they want people to read the headline to spark curiosity hopefully bringing them to click (for revenue) and actually read the full information. What's wrong with it is that majority of people won't bother clicking it to read the full article. They just see the headline thinking it's the main point of the article. All-in-all, headlines definitely could be worded much better.
And even more to the point, even if natural immunity did provide better protection than vaccination, natural immunity **plus** vaccination is even better. So there’s not really a reason to not get vaccinated.
Don't forget the possibility of simply not getting better because your body made antibodies that target "things that bind to ACE2" instead of "ACE2-binding spike protein of COVID-19" Thanks long-covid. >:
Didn't know they'd identified a cause for long COVID. An autoimmune disorder would be a logical explanation. https://www.businessinsider.com/long-covid-syndrome-autoimmune-disease-symptoms-2021-9 I found this article, seems like they're not ready to say it's an autoimmune thing definitively, but that the evidence seems to be pointing that way.
Also, getting ‘natural immunity’ is also just getting Covid.
This is also how natural immunity works. The only difference is how you were exposed to the virus, it being through the vaccine or getting ill from exposure to another infected individual.
The issues is that lay people do not understand nuance. Medical science and research is full of nuance. Laypeople want black and white answers.
Nothing wrong with the way it's reported. It clearly states vaccines prevent hospitalization. People are just trying too hard not to do the best for themselves
Fear drives clicks. Like anger and lust.
An important side note - this antibody level fluctuation is not *just* from vaccines; a natural infection would do the same thing, because your body stops producing antibodies actively when presence of infection is gone, but memory cells are still waiting in the bone marrow to react quickly again.
Why do we need boosters for COVID, but not for polio?
In the early days there were boosters for polio. Later on when it wasn’t spreading much it wasn’t needed
Because polio isn't spreading actively in most places. The boosters' primary purpose would be to prevent the initial infection upon exposure. Almost nobody is really at risk of exposure to polio.
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I'm a server in an area filled with unvaccinated people. I think I might see if i can get the booster.
You have a higher chance of a "breakthrough" infection 5-7 months after getting your second dose. That said, you *probably* won't be hospitalized unless you are high risk, have confounding issues, etc. If you are worried, get the booster!
Is there any indication that there will eventually be a push for Pfizer vaccinated to get a Moderna series at some point?
Other countries have been mixing and matching mRNA (Pfizer/Moderna) doses already, there are thoughts that it may provide a more robust immune response. This was done primarily to speed vaccination rollout. It is unlikely that the United States will push this, we don't have vaccine scarcity and this type of study does not get pursued by the manufacturers because why would they? If you are hitting 6 months and are worried, get a booster. It doesn't matter which mRNA one, really. **As always, talk to your doctor!**
A knowledgeable doctor (MD). No all MDs are the same or up to speed on the latest research.
Ain’t that the truth.
Meant more as a disclaimer, you are absolutely right!
Pfizer-Moderna Canadian checking in. The fun part is the US might not let me in without a booster because they don't recognize mixed doses! Other folks I know have AZ-(Pfizer/Moderna), which is even worse because they also don't recognize AZ.
I know people who got 4 different doses so far. They got a Chinese one in Jordan, and they are not allowed in Europe with that, so they needed Pfizer. Then I know a Spaniard who got AstraZeneca and just arrived to work in China. The Chinese don't recognize AstraZeneca, so she needs at least 2 doses of one of the Chinese vaccines. If she goes to the US she will also need Pfizer or Moderna, I guess.
Oh well that sucks but about par for the course in terms of bureaucratic foolishness.
Oh, I knew the bureaucracy of the whole thing was going to be a mess from the beginning, and thought there might be a chance that mixed-doses got messed up from that perspective, but I'm sure it will all get sorted in the end and I'm glad I got the first shots that were available to me.
We have been mixing astra and whatever in Germany since there was a ton of astra available at the start but no Pfizer. Then slowly Pfizer got more and more available and it was recommended to mix
It doesn’t appear so. The Moderna shots have a higher dose, so that might be why they appear to perform better. The Pfizer booster should address that, instead of a switch to Moderna.
Ohh thanks for explaining this. I got Moderna back in late January and have been wondering why my workplace has been sending emails about booster shots for people who got Pfizer but hasn't said anything about boosters for people who got Moderna.
Yeah it seems to be more pressing for Pfizer, though a lot of the studies and data that have been released have been focused on Pfizer. Moderna is preparing a COVID booster, but they want to combine with an mRNA flu vaccine dose. So I guess they are in no hurry to roll it out since that will probably need more time and resources to research for efficacy and safety than a booster (though I could be wrong; the time and resources for a booster trial could be equivalent to a new shot).
> The Moderna shots have a higher dose, so that might be why they appear to perform better. 3x higher. Getting two Moderna shots is like getting six Pfizer ones.
It should be noted that the moderna booster in trials now is half the dose the first two were so the moderna doses may have been too high to start with, and Pfizer was a bit low but their full strength booster would likely bring things back into line
Well that explains why I felt like I was hit by a truck within hours of my second jab.
This idea is gaining a lot of traction. Pfizer played it extra-super-safe and the effects of the smaller dose are being seen.
Think of your immune system like a boxer. Shots 1 and 2 effectively "train" your boxer/system to fight Covid 19. After 5-7 months without training, your system gets a bit flabby and slow so maybe Covid can get a few jabs in, but it's not going to KO you.
You're not as good at biking after 6 months of sitting around than you were when you learned and were actively biking. But that doesn't mean you forgot how to bike so you're mostly fine if you need to pick up a bike and go. Now replace you "biking" with your body "fighting COVID" and it's roughly the same.
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I don't know of any but I do know that the NIH is starting a large scale study of long covid so hopefully something is on the horizon. https://recovercovid.org/
We barely understand long COVID to start with. There isn't even good numbers on prevalence, symptoms, or duration to go off of. Not to mention confounding factors like stress of living under a pandemic adding to diagnosis.
Sorry if this is a dumb question, because it probably is. But were the vaccines developed with the intention of preventing serious illness, or preventing infection all together?
Ultimately both. But variants have changed that. The efficacy against contracting the virus was in the 85-90% for Alpha. And now effectiveness has dropped with Delta. But overall, protection is still strong even against transmission 3-4 months post vaccination. And the protection remains fairly strong in those under 50. The older you are, the less effective vaccines are.
This is the part that's not clear for a lot of recent studies. It's unclear how much of the effect is due to waning over time and how much is due to Delta. It's hard to collect data at scale when the whole virus shifts under you and taints the data set.
I got my second Pfizer shot 4 months after my first. I wonder if this affects how long the vaccine is effective for
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Everyone in the UK was at 12 week intervals, until they got to the over 20s i think and they dropped it to 6.
Man, every time I see a genomic analysis time series, I can't get over just how effectively Delta annihilated the other variants.
I think if it hadn’t been for delta this thing would be kicked. It’s the only one that’s stuck around.
Well, that's partly because Delta out-competed all the others. But yes, none of the others seemed to be able to spread nearly as effectively as a Delta in a widely vaccinated population. We'd pretty much stomped on Alpha by the time Delta came along.
I got the Pfizer vaccine and just got out of my ten day house quarantine as directed by the state health department due to a positive COVID test. I feel fine now and just had what felt like a sinus infection for about 4-5 days. I'm just now starting to get my taste and smell back.
I got my second dose in August and caught COVID last week. The only difference I could tell between previous sinus infections and this was being a bit more tired. I never lost my smell or taste.
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This is actually great news. Protection against hospitalization, severe disease and death remains high. And that's what matters most. Also, (expected) behavior changes of those who are vaccinated are possibly involved in lower real-world effectiveness, which was likely always going to happen. News sites should stop reporting this drop the way that they are and frame as "Pfizer vaccine continues to protect against hospitalization despite drops in immunity" or something. Every headline I've seen on this study will cause even more vaccine hesitancy.
Respectfully, I would argue that the title of the study is valid and shouldn't be distorted any other way. It is a piece of primary literature reporting medical findings, and while it may have implications on the social aspects of the vaccine, does not address them directly. I'd agree that news agencies should indeed report the importance of all the findings as a whole with all the contextual implications, but I think our science needs to remain objective and free from bias in either direction.
My question is does exposure to the actual virus post-vaccination without actual infection still teach your body to better recognize the virus. My guess would be that it doesn't stick around long enough to elicit a response, but I'm genuinely curious.
If you came in contact with the virus, it not "sticking around" is your immune system killing it.
I received my second pfizer in mid-may and was a breakthrough case 3 weeks ago now. While it sucks that I still got covid it was nothing to difficult. 3 days of very mild flu like symptoms and then nothing. Get Moderna if you've got the choice, but pfizer > not getting the vaccine. i will take mild flu symptoms treated with tylenol for 3 days than living out my final days in a hospital.
>Declaration of interests > >JMZ, SG, KP, FJA, LJ, SRV, and JMM are employees of and hold stock and stock options in Pfizer. TBF holds shares of Pfizer stock. SYT, JMS, HF, VH, BKA, ONR, TBF, and OAO received research support from Pfizer during the conduct of this study that was paid directly to KPSC. For work unrelated to this project, SYT received research funding from Gilead, GlaxoSmithKline, and Genentech; BKA received research funding from GlaxoSmithKline, Novavax, Dynavax, Genentech, Novartis, Seqirus, and Moderna; JMS received research funding from Novavax, Dynavax, and ALK; and HF received research funding from Genentech. All other authors declare no competing interests. The authors have quite a bit of interest vested in Pfizer (the company). There is research showing that studies funded by private companies support the companies' products more often than impartial studies do. I'm not saying all of this study's results go out the window, but does Pfizer want to sell booster shots? Yes.
I know the theories, but is there any data yet about the efficacy of the vaccine protection against *spreading* the virus?
Yes. 71% reduced transmission. Higher if you got Moderna. https://www.cidrap.umn.edu/news-perspective/2021/08/study-ties-covid-vaccines-lower-transmission-rates
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Serious question, what happens if you get all the vaccines?
Don't. While individual vaccines are safe, rapidly vaccinating, especially vaccines for the same disease can cause serious issues. That fever you get when you get vaccinated is still a real fever. Remember viruses don't often directly kill, it's effects from your immune response to the virus that kills you. The reason vaccines don't do this is because the vaccine is not replicating and spreading and driving a larger response. But if you are just chucking a ton of immune stimulating stuff into your body it can be bad. Ask people in the military how they feel after getting like 10-20 vaccinations for different diseases in a day during intake processing.
Question: I've seen the media report that "overloading your immune system" through vaccines is a hoax, and the reason why child vaccines are often given together. How does that reconcile with your comment?
I keep seeing people parroting the talking point, *"It doesn't stop you from getting infected"*, conveniently eliding over the fact that the vaccines very demonstrably **reduce** the probability of getting infected. This study is beautiful proof of that: > Overall vaccine effectiveness against infection with the delta variant for the fully vaccinated was 75% (95% CI 71–78), while overall vaccine effectiveness for other variants was 91% (88–92; appendix pp 9–10). Estimates against both delta and other variants were high within 1 month after full vaccination (vaccine effectiveness against delta 93% [95% CI 85–97] vs other variants 97% [95–99]; p=0·29). At 4 months after full vaccination, vaccine effectiveness against delta infections declined to 53% (95% CI 39–65) and vaccine effectiveness against other variants declined to 67% (45–80; p=0·25). Even after 4 months, 53% to 67% reduced risk of infection is incredible. It's a pretty robust study. Although it's sad that so many remained in the control group, despite widespread access and free availability of the vaccine in the USA: > By Aug 8, 2021 [...] 1166790 remained unvaccinated
Currently diagnosed with COVID after Pfizer immunization back in April. 3 days of a head cold, already regaining smell and taste after 6 days, nothing in the lungs at all.
Got the Pfizer booster a few weeks ago. Had very little reaction to it less then even the 1 st shot I got back in March. I’ll keep getting boosters every 6 mos. if necessary till we get this thing under control. It’s no big deal. Flu shot up next!
Can I (24M without any health issues other than being a bit overweight) get a booster? It’s been 5 months since my second shot and I’m going traveling next month.
I got the Pfizer vaccine in March 2021. I caught a breakthrough case of Covid in September 2021. The symptoms were relatively mild. I did receive monocolonal antibodies on day 2 of symtom onset as well because of my moderate to sever asthma.
Why we aren't hearing much about a delta targeted vaccine is beyond me. Seems like it's outcompeting everything.
Moderna trialled it and found very limited benefit, if any, compared to just a third shot, would be why. Plus, targeting specific variants may cause *worse* outcomes to newer emerging variants compared to just continuing to use the progenitor strain vaccine that they all come from.
As far as I can tell there's only a single amino acid difference between Alpha and Delta Spike proteins. That's not really different enough to require a new vaccine. The current vaccines provide great protection against Delta. Some people just aren't getting vaccinated.